Investigation on the death influencing factors and early treatment strategies of unstable pelvic fractures with polytrauma

JIANG Da-tong; XIANG He-ping

doi:10.3969/j.issn.1009-4237.2016.05.002

Abstract：Objective To investigate the death influence factors and early treatment strategies of unstable pelvic fractures with polytrauma. Methods The clinical data of 79 patients with unstable pelvic fractures and polytrauma admitted into the Department of Emergency Surgery of the Second Affiliated Hospital of Anhui Medical University from Jan.2010 to Dec.2014 were analyzed retrospectively.There were 53 males and 26 females.The average age was (37.6 ±9.8) years.Forty-one patients were injured by road traffic,26 patients were injured by falling from high places,7 patients were injured by heavy hit,and 5 patients were injured by others.Forty-three pa-tients received nonoperative treatment;16 patients received interventive treatment and 24 patients received operative treatment.The patients were divided into two groups according to whether the patients died or not: the survivor group(n=68)and the death group(n=11).The clinical data was compared between the two groups to analyze the death factors.The early treatment strategy was also explored through investigating treatment methods.Results E-leven patients died in this study.Univariate analysis revealed that in the two groups,age (t=0.926,P=0.357) and time of admission after injury (t=0.009,P=0.993) had no significant difference.But shock(χ2 =9.050,P=0.003),ISS(t=5.525,P=0.000),the volume of blood transfusion(t=3.820,P=0.000 ) and the number of the injured sites(t=2.976,P=0.008) were factors of death in patients.Further multivariate analysis showed that ISS (OR=1.179,95%CI:1.027-1.353,P<0.05)and the volume of blood transfusion(OR=0.730,95%CI:0.596-0.894,P<0.05) were independent risk factors of death.Conclusion Shock,ISS,volume of blood transfusion and the number of the injured sites are factors of death in patients with unstable pelvic fractures and polytrauma.Bleed-ing control in the early stage is the key for treatment.